Tuesday, 28 August 2012

People with
physical or intellectual disabilities in our society are often regarded as
non-sexual adults. Sex is very much associated with youth and physical
attractiveness and when it is not, is often seen as “unseemly”.

If sex and
disability are discussed, it is very much in terms of capacity, technique and
fertility – in particular, male capacity and technique and female fertility –
with no reference to sexual feelings. This approach ignores other aspects of
sexuality, such as touching, affection and emotions.

Disabled people
not non-sexual

If we accept that sexual expression is a natural and important part of human
life, then perceptions that deny sexuality for disabled people deny basic right
of expression. The perception of people with disabilities as non-sexual can
present a barrier to safe sex education, both for workers who may be influenced
by these views and for disabled people themselves in terms of gaining access to
information and acceptance as sexual beings.

For paraplegic and
quadriplegic people, loss of sexual function does not mean a corresponding loss
of sexuality. Sexual function may be impaired but can, like other functions, be
increased, although fertility is usually lost for men.

After spinal cord
injury the spinal centre for sexual function is generally intact; it is the
communication from the brain to the spinal centre that is usually disrupted.
Unless some sensation in the area of the sexual organs remains, the usual
sensation of orgasm is lost, but phantom orgasm elsewhere in the body may be
experienced. However, the physical and emotional aspects of sexuality, despite
the physical loss of function, continue to be just as important for disabled
people as for non–disabled people.

In addition,
opportunities for sexual exploration among disabled people, particularly the
young, are very limited. There is often a lack of privacy and they are much
more likely than other young people to receive a negative reaction from an
adult if discovered. The general reduction in life choices also has an impact
on self – esteem which in turn affects sexuality.

It is important for
health care professionals, particularly those involved in education programs
with disability workers or disabled people, to understand community attitudes
towards disability and sexuality and the impact of these views upon disabled
people themselves.

Let’s not sexually
discriminate.

Depression and Your Libido

The "new
generation" of antidepressants, of which Prozac is one, have helped return
millions of people worldwide suffering from depression (as well as other
serious conditions such as obsessive compulsive disorder and eating disorders)
to mental health. One of the chief selling points of these drugs has been their
negligible side-effects compared with earlier antidepressants.

However, there is one common side-effect that
is often a serious cause of concern: sexual dysfunction.

At least 30%-60% of
the men and women who take one of the popular newer antidepressants such as
Prozac and Zoloft, experience some degree of sexual dysfunction.

Drug-related sex problems may include erection
and ejaculation impairment in men, loss of lubrication in women, and, in both
sexes, decreased or lost libido and delayed or blocked orgasm.

Some do get it
up when they are down
For many people, the benefits of having their depression lifted far outweigh
any possible sexual problems. There is also the argument that depression itself
usually severely dampens libido. However, there is no question that healthy
sexual function is an important component of quality of life for many people.

Often, as people experience their depression
starting to ease, they feel eager to return to normal life - and that includes
normal sexual behaviour.

Most people don't
need to take antidepressants for their entire lives: once they stop taking the
drugs, their sexual functioning returns to normal. Thus sexual dysfunction may
not be a serious issue for people receiving short-term antidepressant
treatment. But many chronically depressed people require treatment for many
months or years.

For some, sexual
side-effects can be a serious problem that leads them to stop taking the drugs,
often without telling their doctors. This may result in relapse of the
depression, which can be very serious.

What can you do?

There are numerous treatment options if your medication is causing sexual
dysfunction. These options have not been successful in treating
antidepressant-induced sexual problems in everybody, but usually a helpful
alternative can be found.

This is
a chronic, itching, superficial inflammation of the skin, often associated with
a personal or family history of related problems such as hay fever, allergic
conjunctivitis (‘allergic eyes’) and asthma. Doctors and patients often loosely
refer to this condition as ‘eczema’.

The
exact cause is not known. It is felt that interaction of many factors leads to
the development of atopic dermatitis. The latest research shows that atopic
dermatitis sufferers may have a (genetically) inherited skin barrier defect.
This makes the skin dry and strips it of its natural protection from infections
and substances that may cause an allergic reaction or irritation. These
patients also seem unusually prone to develop inflammation. People who suffer
from atopic dermatitis often have high levels of an immune substance called
IgE.

Atopic
dermatitis is becoming far more common, a trend that is being noticed in many
other allergic diseases.

Food
allergy may be associated with atopic dermatitis in infants and young children;
however there is no evidence of any role of food allergy in teenagers and
adults. Your GP or dermatologist can test your child for common food allergies
with a simple blood test (Fx5) or using skin prick testing. This is only indicated
if there is a poor response to treatment or a very clear history of
food-associated flares.

A common
sensitivity amongst atopic dermatitis patients is to house dust mite. This may
be assessed using skin prick tests. This allergen is however extremely
difficult to avoid.

Things
that tend to cause atopic dermatitis flares include: staphylococcus growth on
the skin, destruction of the skin barrier, exposure to allergens, exposure to
irritants (e.g. rough clothing like wool, soaps) and stress.

The condition may start within the
first few months of life with red, weeping, crusting lesions on the face,
scalp, and the limbs.

In older children or adults it may be
more localised and chronic.

The redness and thickened skin is most
commonly found in the creases in the elbows and knees, the eyelids, neck
and wrists. The rash may become more widespread across the rest of the
body.

Itching is a constant feature. The
constant itch leads to rubbing and scratching, which in turn leads to more
itching. Itching is made worse by the dryness commonly observed in these
patients.

Secondary bacterial infections and
swollen glands are common.

Because people with atopic dermatitis
often use drugs, over-the-counter or prescribed, contact dermatitis
frequently complicates this condition. There are many substances that
irritate the skin and can exacerbate the condition.

Emotional stress, temperature or
humidity changes, bacterial skin infections and wool can also aggravate
the condition.

Diagnosis
is usually clinical – which means the doctor examines the skin condition and
asks questions to make the diagnosis. It is based on the location of the
lesions, how long they have been there and whether there is a family history of
allergic disorders. In some cases, if the doctor is not certain of the
diagnosis, he/she may take a piece of skin for examination under a microscope
(a biopsy). Your doctor may in some cases recommend patch tests, skin prick
tests or blood tests for specific allergens. In most cases these are
unnecessary.

Saturday, 11 August 2012

Guess what I don’t drink alcohol and never touched it in my life
but I can’t help ask why people drink themselves to comatose. I do have
relatives and friends who abuse alcohol and it has always been a mystery to me.
In one of my articles I did look at alcohol abuse and this is a continuation.Be warned and know your facts.

Effects of Alcohol

Here is how it works according to research,

The effects of alcohol hit your brain like a tidal wave. You can
go from jovial, to falling-down drunk, to dead and it doesn't take very long to
get there.

Firstly it suppresses the frontal lobes, then it goes to the back
of your brain, and then to the parts deep in the centre.

Alcohol is a suppressant as it suppresses the normal functions of
your brain.

This suppressing effect on the brain is almost like a wave
crashing over your head. First it suppresses the frontal lobes, then it washes
further backwards over the parietal lobes, then to the parietal lobes, the
occipital lobes right at the back, then deeper into the brain to the cerebellum
and lastly to the diencephalon and the mesencephalon (midbrain), and then down
to the brainstem and the medulla oblongata.

This process is continuous, but certain functions, for example
peripheral vision, may already be affected at an earlier stage.

The jovial phase

The frontal lobes house the functions that control, among other
things, your inhibitions, self-control, willpower, ability to judge and
attention span.

Suppress it, and your self-confidence increases, you start getting
jovial, you become more and more generous, and start talking more. This is why
alcohol is seen as a good social lubricant.

This effect can already be detected with blood alcohol levels as
low as 0,01g/100ml - in other words, while you are within the legal limit of
0,05g/100ml.

The problem is that even at this level, which is perfectly legal,
your loss of judgement ability and your changed personality already increase
your risk of dying an unnatural death, for example as a result of being in a
fight.

Maybe you are better able to control yourself and your behaviour
in this phase as a result of good self-control, or education, and the onslaught
of the alcohol might pass by relatively unobtrusively, or, maybe not.

The slurring phase

The next parts of the brain that come into the firing line, the
parietal lobes, are affected at a blood alcohol level of approximately 0,10
g/100ml.

This is when your motor skills become impaired, you have
difficulty speaking, except in a in slurred fashion (which oddly enough, you
cannot hear yourself), you start shivering, and complicated actions become very
difficult to execute (I always used to watched alleged drunk drivers trying to
fasten their shirt buttons – an everyday activity that suddenly becomes as
difficult as threading a needle). At the same time your sensory abilities are
hampered.

The can’t-see-properly phase

The occipital lobe is reached when the alcohol level is usually at
about 0,15 g/100ml.

Your visual perception ability becomes limited. You experience
increased difficulty with movement and distance perception. Your depth
perception becomes impaired and your peripheral vision decreases. If, at this
stage, you drive at dusk, you will have great difficulty seeing a little boy
chasing a ball, or your fellow drinking buddy, staggering by the roadside.

The falling-down phase

At about the alcohol level of 0,20 g/100ml the cerebellum becomes
affected and maintaining your balance could become difficult.

With a bit of luck, by this time your friends will have placed you
somewhere safe.

The down-and-out phase

I hope you are lying down in a safe place, because at this stage
the wave is crashing at 0,25 g/100ml over your diencephalon and the mesencephalon
(midbrain).

You become tired and very unsteady – you are now probably out for
the count.

You start shaking and you vomit. Maybe your reflexes will not be
so badly suppressed that you cannot protect your airways, otherwise you could
inhale your own vomit and die. Your consciousness is now suppressed, and you
may be comatose.

In the valley of the shadow of death phase

Should the alcohol wave wash further, driven by a blood alcohol
level of 0,35 tot 0,40 g/100ml, and it reaches your brain stem, including the
medulla oblongata, you have life-threatening problems. The centres controlling
your breathing and your blood circulation are suppressed, and you are busy
dying.

The chronic drinker

These effects refer to the social drinker. Chronic abuse of alcohol
will increase someone's tolerance, and would therefore cause these effects to
become visible only when a chronic drinker has reached much higher levels of
alcohol in the blood than those mentioned above.

Usually the person would appear to be less under the influence at
a specific blood alcohol concentration (BAC), when the BAC is busy dropping,
than when it is busy increasing. This is called the Mellanby effect, and is the
result of the development of acute tolerance in the brain with regards to alcohol.

Friday, 10 August 2012

All that is born gets old and it is every one‘s responsibility to
care and support the elderly. However there are people who take advantage of
ageing relations or clients and make their life hell. A friend of mine’s
grandmother lost all she had to unscrupulous relations. Be on the lookout for
loved ones who might be abused by the cruel and heartless.

What is abuse?

Abuse is the improper usage or
treatment for a bad purpose, often to unfairly or improperly gain benefit.

Financial abuse/exploitation: misuse of
funds and assets or obtaining property or funds without full consent, knowledge
or under duress, e.g. extortion, coercion

Active or passive neglect: withholding or
not providing the care and basic necessities required for physical and mental
well being e.g. food, warmth, clothing, essential medication.

Sexual abuse: sexual behaviour towards a
person without their full knowledge and / or consent, e.g. sexual assault,
harassment.

Violation of human rights: the denial of
fundamental rights - the right to freedom, security, accurate information and
not to be subjected to cruel and inhuman or degrading treatment e.g. respect
for dignity, personal privacy, freedom of thought, belief opinion, speech,
expression and movement.

Systemic abuse: any abuse or violation of human
rights suffered by an elderly person or group of elderly persons as a result of
an action or inaction by a statutory body or the state.

Withcraft: Elderly black people, mainly women,
are sometimes "identified" as witches by others in the community, and
along with their hut they are set alight and burnt to death. It is reported
that those "identified " as witches often have particularly wrinkled
or darkened skins due to age, or are reclusive or independent and successful.
It is also reported that a reason to rid an elderly person from the community
might be motivated by the wish to obtain the elderly persons' property or
possessions.

Below is a list of possible indicators of neglect
by caregiver

dirt, faecal/urine
smell, or other health and safety hazards in elder's living environment

Tuesday, 7 August 2012

Violence
against anybody is wrong and a crime against humanity but on children it is
worse.

All over the world, children with disabilities are
suffering from sexual violence at the hands of perpetrators who operate with
almost total impunity. Almost as shocking as the abuse itself is the fact that
so little is known about it.

Sexual Violence

Sexual
violence against any children is a gross violation of children’s rights. Yet it
is a global reality across all countries and social groups. It takes the form
of sexual abuse, harassment, rape or sexual exploitation in prostitution or
pornography. It can happen in homes, institutions, schools, workplaces, in
travel and tourism facilities, within communities - both in development and
emergency contexts.

In many countries,
violence against children such as corporal punishment, remains legal and
socially accepted. Growing up with violence seriously affects a child's
development, dignity, and physical and psychological integrity.

The violence children face takes many forms, such as
sexual exploitation and abuse, trafficking, physical and humiliating
punishment, harmful traditional practices (including early marriage and female
genital mutilation/cutting) and recruitment into armed forces and groups.

Increasingly,
the internet and mobile phones also put children at risk of sexual violence as
some adults look to the internet to pursue sexual relationships with children.
There is also an increase in the number and circulation of images of child
abuse. Children themselves also send each other sexualized messages or images
on their mobile phones, so called ‘sexting’, which puts them at risk for other
abuse.

In 2002,
WHO estimated that 150 million girls and 73 million boys under 18 years
experienced forced sexual intercourse or other forms of sexual violence
involving physical contact (United Nations study on violence against children).

Millions more are likely exploited in
prostitution or pornography each year, most of the times lured or forced into
these situations through false promises and limited knowledge about the risks.
Yet the true magnitude of sexual violence is hidden because of its sensitive
and illegal nature. Most children and families do not report cases of abuse and
exploitation because of stigma, fear, and lack of trust in the authorities.
Social tolerance and lack of awareness also contribute to under-reporting.

Evidence
shows that sexual violence can have serious short- and long-term physical,
psychological and social consequences not only for girls or boys, but also for
their families and communities. This includes increased risks for illness,
unwanted pregnancy, psychological distress, stigma, discrimination and
difficulties at school.

Children are often afraid to report incidents of
violence. In many cases parents remain silent if the abuse is perpetrated by a
spouse or family member or a more powerful member of society, such as an
employer, a police officer, or a community leader.

Physical Punishment

Physical
and humiliating punishment is the most common form of violence against
children. However, it remains lawful and widely socially accepted in all but 32
states (June, 2012). This means that more almost 95 per cent of children in the
world do not have the same protection against this form of violence as adults.

Children continue to be physically punished and
deliberately humiliated in almost all societies and across all cultures as this
practice remains far too common at home, in schools and institutions:

Physical and humiliating punishment in schools has been
abolished in over 100 states but is still considered and practiced to
discipline children in schools in most countries.

Only 1 out of 10 children live in a country where
physical and humiliating punishments are forbidden in all alternative care
settings.

It is still lawful to sentence children to caning,
whipping or flogging in the penal systems of 145 states all over the world.

This form of violence might be a deliberate act of
punishment or just the impulsive reaction of an irritated adult. Regardless of
which, it is still a breach of the universal principle that all human beings
should be treated with respect for their human dignity and their right to
physical integrity.
One main reason for physical punishment is that caregivers or teachers see no
other way of correcting the child’s behavior and instill discipline.

However, it has been proven that physical and humiliating
punishment is not only a violation of children’s human rights but is also
ineffective as a means of discipline. In addition, a commitment to ending all
forms of physical and humiliating punishment is a priority because:

It
is a violation of children’s right to protection, but can also threaten children’s rights to education, development,
health and even survival.

It
can cause serious physical and psychological harm to the children

It
teaches the child that violence is an acceptable andappropriate strategy for resolving conflict or getting
people to do what you want.

It
may give the impression that some forms or levels of violence against children are legitimate which makes protection of
children difficult in general.

It
encourages children to be aggressive, creates anger and resentment and damages the parent-child relationship.

Child labour

Children work in rich as well as in poor countries. The
biggest number of working children is found in Asia.
This is not surprising as this is where most children live. The highest
proportion of working children is found in Africa,
where one child in four is engaged in ’child labour’

Reasons: In order to protect children from workplace
abuse, it is important to understand the reasons for children’s entry into to
labour market. There is much evidence to suggest that many children work for
their own or their family’s survival.

A lack
of access to good quality, relevant education is regarded as another key reason
for children’s work, as governments have failed to ensure that education is
genuinely free, or to invest in improvements in the quality of schooling.
Negative attitudes and lack of skills among teachers, and the levels of abuse
in schools, are factors that children and their families take into account when
they regard work as more relevant than school.

Structural
inequalities are important determinants of the types as well as the amounts of
work that girls and boys do. For example, children may be discriminated against
on the grounds of gender, ethnicity or disability, leading to exclusion from
school, limited employment prospects and little choice but to work in harmful forms
of work. When gender norms prevent women from entering paid employment,
children might have to join the workforce.

Seemingly
unrelated issues like HIV/AIDS, conflict and climate change, can have a major
impact on child work. For example, the HIV/AIDS pandemic has reduced the adult
workforce and diverted expenditure away from social protection and education,
pushing boys and girls into harmful work. Conflict can lead to an increase in
child soldiers and to children being separated from their families, becoming
vulnerable to exploitation. Environmental disasters associated with climate
change can increase household vulnerability, forcing children to work to
enhance the amount or stability of incomes.

Children living without Proper Care

Children
without appropriate care' encompasses a broad range ofchildren who are not receiving suitable, continuous
and quality care, nurture
and guidance at a physical, emotional, social and psychological level from
either their families or from other primary carers that are meant to replace
the family environment and are responsible for their well-being and development.
The number of children living without appropriate care is staggering.

• The
world is home to 18.3 million orphans

• There
are more than 15 million children under the age of
18 who have
lost one or both parents to AIDS

• More
than onemillion
children are trafficked every year

• An
estimated eight million children around the world are living in

care
institutions, such as orphanages

• In
the last decade, an estimated 20million children were forced to flee
their homes

• More
than one million have been orphaned or separated from their
families by an emergency

Children are often afraid to report
incidents of violence. In many cases parents remain silent if the abuse is
perpetrated by a spouse or family member or a more powerful member of society,
such as an employer, a police officer, or a community leader.

There are many charities that are helping
children across the world like Save the Children and many others. Lets all help
protect children.

Sunday, 5 August 2012

Recently I was contacted by a long lost
friend and she had come back to the land of the living with a shocking story.
She is a victim of human trafficking. She has however managed to break away
recently. I will be featuring her story in this blog but I thought I should
share with you the fact on human trafficking. It is not only an African issue
but affects all of us. Whoever you are please say no to this evil
practice. Sometimes people are recruited without knowing to smuggle victims in
and out of other countries.

What is Human Trafficking?

Human Trafficking is a crime against humanity. It
involves an act of recruiting, transporting, transferring, harbouring or
receiving a person through a use of force, coercion or other means, for the
purpose of exploiting them. Every year, thousands of men, women and children
fall into the hands of traffickers, in their own countries and abroad.

Elements of human trafficking

On the basis of
the definition given in the Trafficking in Persons Protocol, it is evident that
trafficking in persons has three constituent elements;

Threat or use of
force, coercion, abduction, fraud, deception, abuse of power or vulnerability,
or giving payments or benefits to a person in control of the victim

The Purpose (Why it is done)

For
the purpose of exploitation, which includes exploiting the prostitution of
others, sexual exploitation, forced labour, slavery or similar practices and
the removal of organs.

To ascertain whether a particular circumstance
constitutes trafficking in persons, consider the definition of trafficking in
the Trafficking in Persons Protocol and the constituent elements of the
offense, as defined by relevant domestic legislation.

Human trafficking in Africa
is a serious problem and warrants intervention on all fronts. Many African
States still do not have legislation on human trafficking, or only have laws
that criminalize some aspects of human trafficking (such as child trafficking).

Nearly
130,000 people in sub-Saharan Africa and 230,000 in the Middle East and North Africa have been recruited into forced labour,
including sexual exploitation, as a result of human trafficking. These
estimates by the International Labour Organization paint a grim picture of
human trafficking in Africa. Although a large
number of victims of human trafficking of African origin are found within the
continent, many are also transported to Western Europe
and other parts of the world, according to a recent UNODC report on trafficking
in persons world wide

Young boys
are trafficked to smuggle drugs and for other criminal activities.

Research shows on the following:

Intercontinental trafficking (to South Africa from outside of Africa).

South Africa is a destination
county for long-distance flows for people (mainly women) trafficked from Thailand,Philippines,
India, China, Bulgaria,
Romania, Russia and the Ukraine. The main point of entry of
this trafficking stream is OR Tambo Airport in Johannesburg.

Trafficking to South Africa from other African
countries. People are trafficked from within Africa across the extensive land
borders of South Africa,
mostly from Mozambique and Zimbabwe and to a lesser extent Malawi, Swaziland
and Lesotho.
Longer-distance trafficking involve victims trafficked from the Democratic
Republic of Congo (DRC), Angola,
Rwanda, Kenya, Cameroon,
Nigeria and Somalia. All
documented cases in this last category are women trafficked for both sexual and
labour exploitation.

Domestic trafficking. The largest
movement of trafficked people is from rural areas to cities. Women, girls and
boys -and to a lesser extent, men - are the targets of traffickers for
prostitution for the same purposes listed. The albino community was identified
as vulnerable to human traffickers for the harvesting of body parts, due the
belief of a ‘white' skin having potent powers.

Research shows trafficking in Southern Africa as
rampant and destination countries include Ireland,
Zimbabwe, Israel, Switzerland,
the Netherlands and Macau. In all cases, the victims were women trafficked
for either sexual exploitation, labour exploitation or forced marriage.

The study confirmed that, as elsewhere, women
constitute the largest group of victims in human trafficking in Southern Africa, with the main purpose of sexual
exploitation. Young girls are also trafficked for sexual exploitation because
they are perceived to present less of a risk in terms of HIV and AIDS and
because of the ‘sexual desirability of youth'.

Some of the findings include:

Perpetrators

Human trafficking is driven by networks situated in
source countries with links to South
Africa as the destination country.
Perpetrators and intermediaries include large organised-crime networks. South
African men with ex-military backgrounds work together with these syndicates.

Relationship of human trafficking to other forms of
crime

There is a distinct trafficking-narcotics nexus, as
criminal syndicates are usually involved in several areas of illegal activities
- including smuggling, weapons and narcotics trafficking. Trafficked women may
also be involved in the ancillary line of selling drugs to their clients. In
many cases of trafficking for sexual exploitation, victims are made dependent
on narcotics to reduce their capacity to leave. Young boys are also trafficked
to sell drugs.

Collusion of officials as facilitating factor

The collusion of border and other immigration
officials is a key factor facilitating trafficking. Human trafficking
syndicates target border posts where lax border controls and vulnerability to
bribery enable the illegal transportation of a variety of goods. The Lebombo
border was identified as one of the land ports of entry where these problems
operate on a large scale. The same problems were cited regarding OR Tambo
Airport.

Aggravating factors

Factors that facilitate and aggravate human
trafficking in Southern Africa include poverty and inequality; the lack of
educational and employment opportunities in surrounding countries and within
the country; lax security at ports of entry; collusion of government officials;
the lack of trained personnel to identify and handle trafficking cases; and
societal beliefs that tolerate violence against women and children.

How to Help

Be aware that this is a crime that can be prevented
and for those looking for greener pastures elsewhere be aware you can be duped
into modern slavery. Virtually
every country in the world is affected by these crimes. The challenge for all
countries, rich and poor, is to target the criminals who exploit desperate
people and to protect and assist victims of trafficking and smuggled migrants,
many of whom endure unimaginable hardships in their bid for a better life.

Vocational training can reduce the risk of them
being sucked into exploitative situations again.

Wednesday, 1 August 2012

This article is for any
family that has gone through some stigma for having a family member with mental
health issues. I was thinking the other day of a lady I knew while I was
growing up. She had a mental health condition and she walked about the streets.
Unfortunately she was always available for men to sleep with and most of the
time she had what I think was a sexually transmitted. The whole family was so
isolated even the father and other family members were shunned. Such was the
lack of knowledge on the members of the community. A little bit of support would
have made a difference to the family. I never knew what happened to the lady
but hers is not the only family going through that stigma. For all families with
ADHD and any other conditions, you are not alone. I am no expert but knowledge
is power and it makes all the difference. In Africa
I have known families accusing relatives of witchcraft due to lack of knowledge
of mental health conditions.

ADHD is a disorder characterised by three
primary symptoms: hyperactivity, impulsivity and inattention (difficulty
focusing and sustaining attention).

There are three types; inattentive type,
impulsivity-hyperactivity type and a combination type including both
inattention and impulsivity-hyperactivity.

ADHD is a neurological condition and runs in
families.

Diagnosis requires a comprehensive assessment
and involves a team of professionals.

Treatment includes medical, psychological and
educational intervention as well as behavioural management.

With appropriate intervention and support,
people with ADHD can function successfully in society.

Occasionally, we may all have difficulty sitting
still, paying attention or controlling impulsive behaviour. For a person with
ADHD, though, these problems become so pervasive and persistent that their
ability to function effectively in daily life is compromised.

ADHD is a neurological syndrome, found in
children as well as adults, that is characterised by poor concentration and
organisational skills, easy distractibility, low tolerance for frustration or
boredom, a greater tendency to say or do whatever comes to mind (impulsivity)
and a predilection for situations with high intensity.

The name Attention-Deficit Hyperactivity
Disorder reflects the importance of the inattention/ distraction aspect of the
disorder as well as the hyperactivity/ impulsivity aspect. The disorder ADHD
symptoms arise in early childhood, unless associated with some type of brain
injury later in life.

ADHD is caused by differences in
neurotransmitter patterns in certain parts of the brain. Neurotransmitters are
chemicals that make it possible for nerve impulses to travel from one nerve
cell to another, and therefore play an essential role in the functioning of the
brain. The brain performs a vast range of tasks or functions, allowing us, for
instance, to see, hear, think, speak and move. Each function is performed by a
different part of the brain. In individuals with ADHD there are lower than
normal levels of certain neurotransmitters (especially dopamine) in the regions
of the brain that are responsible for regulating behaviour and attention.
Research also confirms that the Norepinephrine system is also involved in some
patients.

ADHD has a genetic component and a group of
genes involved has been identified. The genetic component is confirmed with
epidemiological studies looking at family groups. Research has shown that in
the case of identical twins, if one of the twins has ADHD there is an almost
100% chance that the other twin will show symptoms of ADHD.

ADHD can also be present in some patients with
neurological damage occurring either before or after birth. Certain
developmental disorders or syndromes, like Foetal Alcohol Syndrome, are
associated with a higher incidence of ADHD.

Diet is often cited as the cause for ADHD.
Patients with malnutrition or a poor diet may manifest some of the symptoms. In
a small subgroup dietary factors may play a role in the worsening of symptoms,
especially that of impulsivity/hyperactivity in younger children. Ongoing
research is looking at the role that essential fatty acids play in some
patients. Poisoning with heavy metals like lead will create a similar clinical
picture in some patients.

Although environmental factors do not play a
causal role in ADHD, a disorganised, chaotic and stressful environment can
cause behaviour which mimics that of ADHD.

Clinically they present as the classical dreamers, disorganised and often living
in their own little world. This leads to major problems with planning and task
completion.

ADHD primarily hyperactive/impulsive type

Fidgets with hands or feet or
squirms in chair.

Has difficulty remaining
seated.

Runs about or climbs
excessively.

Difficulty engaging in
activities quietly.

Acts as if driven by a motor.

Talks excessively.

Blurts out answers before
questions have been completed.

Difficulty waiting or taking
turns.

Interrupts or intrudes upon
others.

The classical hyperactive group are often a danger to themselves because of the
impulsive behaviour.

ADHD combined type

The individual meets both sets of inattention
and hyperactive/impulsive criteria, constantly fidgeting and busy with
something other than what it expected of them at that moment.

Coexisting disorders

In studies as many as 60 percent of individuals
with ADHD present with at least one other major disorder. The most common of
these coexisting disorders are briefly described below.

Disruptive Behaviour Disorders

Oppositional-Defiant Disorder (ODD) and Conduct
Disorder (CD): ODD involves a pattern of arguing with multiple adults, losing
one's temper, refusing to follow rules, blaming others, deliberately annoying
others, and being angry, resentful.
CD is associated with efforts to break rules without getting caught. Such
children may be aggressive to people or animals, destroy property, lie or steal
things from others, run away, be truant from school, or break curfews. CD is
often described as delinquency.

Mood Disorders

Depression
ADHD is often associated with depression, which usually appears after ADHD has
developed. Depression is characterised by sadness (a child may cry frequently,
and for no apparent reason), social withdrawal, loss of appetite, self
recrimination, insomnia or excessive sleeping, and a loss of interest in
activities that were previously enjoyed.

Mania/Bipolar Disorder
Bipolar Disorder may present with symptoms of ADHD in the pre-pubertal child. A
family history of bipolar disorder is an important indicator. This disorder
takes the form of periods of abnormally elevated mood (mania) alternating with
episodes of depression. In children, the manic phase can manifest as pervasive
irritability and unprovoked aggression.
The manic phase in adults is usually characterised by an expansive mood, such
that the person feels euphoric and extremely confident. The manic individual
may go for days without sleeping, tends to speak rapidly and incessantly, and
is inclined to behave inappropriately in social settings (having lost their
normal inhibitions). During a manic phase people often develop an unrealistic
belief in their capabilities, as a result of which they engage in activities or
projects which are doomed to failure and which often lead them into financial or
other difficulties.

Anxiety

Approximately one third of children with ADHD
will also have an anxiety disorder. People with anxiety disorders often worry
excessively about a number of things and may feel edgy, stressed out or tired,
tense, and have trouble getting restful sleep. A small number of patients may
report brief episodes of severe anxiety (panic attacks) with complaints of
pounding heart, sweating, shaking, choking, difficulty breathing, nausea or
stomach pain, dizziness, and fears of going crazy or dying. These episodes may
occur for no reason.

Tourette's Disorder

About seven percent of those with ADHD have
Tourette's Disorder. This disorder involves movements and vocal tics. Tics are
sudden, rapid, recurrent, non-rhythmic, involuntary movements or vocalisations.
The diagnosis of ADHD may precede the onset of tics.

Learning Disabilities

Up to 60 percent of individuals with ADHD have
some form of learning disability. Learning disabled persons may have a specific
problem reading or calculating, but usually have normal IQ. Dyslexia may have a
major impact.

Substance Abuse

Recent research suggests that adolescents with
ADHD are at increased risk for very early cigarette use, which is likely to be
followed by alcohol and drug abuse if their symptoms are not controlled.

Three to five percent of children are affected
by ADHD. Until recent years, it was believed that children outgrow ADHD in
adolescence. Hyperactivity often does diminish during the teen years, but it is
now known that symptoms can continue into adulthood. In fact, up to 65 percent
of children with ADHD will continue to exhibit symptoms in adulthood and in a
major proportion it may still have a negative impact on their functioning in
all aspects of life and society.

Males are far more likely to get ADHD, with the
ratio of males to females with ADHD being 3 to 1. However, ADHD tends to be
under-diagnosed in girls as they more frequently present with the inattentive
type, which is more difficult to identify than the hyperactive-impulsive type.

In certain conditions a higher incidence of ADHD
are found i.e. Tourette’s syndrome or Foetal Alcohol Syndrome.

There is no single test to diagnose ADHD.
Instead, a comprehensive evaluation is necessary to:

reach a diagnosis rule out
other causes for the symptoms

establish whether coexisting
conditions are present.

Such an evaluation requires time and effort and
should include a clinical assessment of the individual’s academic, social and
emotional functioning. In children, a careful history should be taken from
parents and teachers. Often, both a psychologist and a medical practitioner,
usually a psychiatrist or a paediatrician, should be involved in the assessment
process.

Before reaching a diagnosis, it is important to
rule out the following conditions, which usually manifest similar symptoms to
those of ADHD.

Emotional difficulties/social
and environmental problems.

Low Muscle Tone – some children
have to focus so hard on sitting up straight that they fidget more.

Motor-co-ordination
difficulties – if present this often leads to problems with task
completion and the quality of work presented. It often coexists in
patients with ADHD.

Sensory Modulation Disorders –
These children have problems being tactile or light defensive. The noise
defensive child has difficulty blocking out background noise when having
to pay attention.

Global development delay -
concentration and functioning should be evaluated according to functional,
not chronological age.

Absence Epilepsy - often
presents between ages six - 10 years.

It is important to realise that some of the
above can also be present in patients with a classical picture of ADHD. Other
problems may present with symptoms suggestive of ADHD but often leads to a
later diagnosis because the interaction with concentration problems is not
explored. They often coexist.

In order for a diagnosis of ADHD to be made the
following conditions should be met

Some symptoms must have
appeared by the age of seven.

At least six symptoms must be
present and must have persisted for at least six months.

Symptoms must occur in at least
two different settings (for example, at school and at home).

The symptoms must cause
significant impairment of social and academic functioning.

It is imperative that children who present with
ADHD receive appropriate and adequate treatment.

Treating ADHD in children requires medical,
psychological and educational intervention, as well as behavioural management.
It therefore requires a team approach and also includes parent training.
Parents need to be educated on how to cope with and assist a child with ADHD.
Parental support is a crucial component in any successful treatment programme.
Positive reinforcement, in which desired behaviour is rewarded, is the most
appropriate and effective form of behavioural management. It is important that
reinforcement is consistently applied.

Many children with ADHD can be taught in a
regular classroom with minor adjustments to the environment, but some children
require additional assistance using special educational services, especially if
they have complex learning difficulties.

Treatment for adults with ADHD involves medical
intervention and psychotherapy. Psychotherapy is important because adults with
ADHD need to be helped to understand that their educational, vocational and/or
personal difficulties are not the result of an irremediable personality flaw.

Patients with ADHD often present with emotional
difficulties and problems due to the negative impact of ADHD on their lives.
Psychotherapy and coaching helps with understanding the condition, taking
control of the symptoms and making better choices.

Quotes

Married to a Devil

About Me

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I write about issues that affect women mostly in the underdeveloped parts of the world. My first book is called 'Married to a Devil'.
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